Caesarean scar ectopic pregnancy: imaging findings of this rare but potentially life-threatening condition

Caesarean scar ectopic is one of the rarest of all ectopic pregnancies. The incidence of caesarean scar ectopic has increased due to increase in number of caesarean deliveries. A 31-year-old woman (G4P3003) presented from an outside facility to Sola Civil Hospital with vaginal bleeding and discharge with no abdominal pain or any discomfort. The gestational sac was located in an anterior position toward the anterior lower uterine segment at the level of prior caesarean scar with little visible myometrium noted anterior to the gestational sac in the lower uterine segment and Tissue was sent for histopathological examination and diagnosis of caesarean scar ectopic pregnancy was confirmed. Reports found that It is life threatening condition, causes excessive hemorrhage and risk of uterine rupture. The diagnosis of this type of ectopic pregnancy is very difficult and false negative diagnosis can lead to major complications.

Download Full-text

Heterotopic pregnancy; case report

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v7i05.425 ◽

2019 ◽

Vol 7 (05) ◽

Author(s):

Vipul R. Khandagale

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Adnexal Mass ◽

Heterotopic Pregnancy ◽

Free Fluid ◽

Threatening Condition ◽

Life Threatening ◽

Ectopic Pregnancies ◽

High Index Of Suspicion ◽

Low Risk Women

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.

Download Full-text

Recurrent ipsilateral ectopic pregnancy after partial salpingectomy: case-report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182908 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2930

Author(s):

Tanjona Andriamanetsiarivo Ratsiatosika ◽

Romuald Randriamahavonjy ◽

Baco Abdallah Abasse ◽

Mahefarisoa Fnat ◽

Ibrahim Housni ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Ectopic Pregnancy ◽

Fallopian Tube ◽

Vaginal Bleeding ◽

Postoperative Recovery ◽

Common Site ◽

Threatening Condition ◽

Life Threatening ◽

Bilateral Salpingectomy

Ectopic pregnancy is a life-threatening condition occurring in 1-2% of all pregnancies. The most common site of implantation for an ectopic pregnancy is the fallopian tube. Authors report a case of recurrent ipsilateral ectopic pregnancy following right partial salpingectomy of a 29-Year-Old woman that led to tubal rupture. The pregnancy was conceived spontaneously. Diagnostic of ruptured ectopic pregnancy was done after clinical and ultrasonography examination. The presence of a massive hemoperitoneum with a positive pregnancy urinary test that lead us to the diagnosis of ectopic pregnancy. She underwent a laparotomy for a suspicion of ruptured ectopic pregnancy. The ectopic pregnancy was identified in the left remnant fallopian tube. Partial salpingectomy, removal of tubal stump, and resection of the uterine cornua, was performed. The postoperative recovery was uneventful. She has stayed for five days at the Hospital. All patients, even though they have already received a definitive contraception by tubal section and ligature or unilateral or by bilateral salpingectomy for any reason, must seek an ectopic pregnancy in case of pelvic pain, vaginal bleeding and/ or amenorrhea. Authors propose to carry a total salpingectomy after a chosen surgical treatment.

Download Full-text

Caesarean scar ectopic pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181952 ◽

2018 ◽

Vol 7 (5) ◽

pp. 2038

Author(s):

T. Ramani Devi ◽

T. Sweta ◽

C. Archana Devi

Keyword(s):

Ectopic Pregnancy ◽

Conservative Management ◽

Abdominal Cavity ◽

Delayed Diagnosis ◽

Reproductive Age ◽

Mortality And Morbidity ◽

Caesarean Scar ◽

Future Fertility ◽

Laparoscopic Excision ◽

Life Threatening

Ectopic pregnancy is a common cause of mortality and morbidity among the women of reproductive age group. Tubal pregnancy is the commonest. It can occur in cervix, ovaries, previous caesarean scar, interstitial portion of the tube and abdominal cavity. Here we report a case of caesarean scar ectopic pregnancy which was managed conservatively. 31 yrs old gravid 3 previous 1 LSCS and 1 tubal ectopic come for antenatal consultation at 35 days of gestation. UPT was Positive. USG showed no evidence of intra uterine sac. Repeat scan after 10 days showed a gestational sac at the lower uterine segment scar. Hence it was decided for conservative management, injection methotrexate 50 mgm X 2 doses given. This was followed by misoprost vaginal insertion. Since patient did not expel the sac, injection PG F2 alpha 125 mg x 2 doses were given. Patient expelled the products of conception partially. This was followed by hysteroscopic guided evacuation.Caesarean scar ectopic was reported in 1978. Early diagnosis is by TV USG / MRI. Early ectopic can be treated medically. In delayed diagnosis, laparoscopic excision of the scar has to be done. In rupture of the scar site ectopic pregnancy laparotomy is indicated. In the event of heavy bleeding, hysterectomy has to be done. After conservative management and excision of the scar, fertility is not altered. Caesarean section scar pregnancy is a rare form of ectopic pregnancy which can lead to life threatening complications leading to mortality and morbidity. Treatment has to be individualized according to the gestational age, haemodynamic stability and desire for future fertility.

Download Full-text

Caesarean Scar Pregnancy - A Rare Case Report

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v27i2.29924 ◽

2016 ◽

Vol 27 (2) ◽

pp. 83-86 ◽

Cited By ~ 1

Author(s):

Razia Sultana ◽

Saiful Islam ◽

Nurjahan

Keyword(s):

Case Report ◽

Caesarean Section ◽

Ectopic Pregnancy ◽

Transvaginal Sonography ◽

Emergency Laparotomy ◽

Colour Doppler ◽

Caesarean Scar ◽

Incomplete Abortion ◽

Rare Case Report ◽

Life Threatening

Objective:The aim is to publish the case report of the rarely occurring and life threatening ectopic pregnancy developing in a Caesarean section scar causing uterine rupture.Methods and Results: This patient was diagnosed initially as a case of incomplete abortion. Other possible diagnoses were molar pregnancy, mass in the cervix. She was admitted in hospital for evacuation and curettage. During the procedure she developed severe pervaginal bleeding leading to hypovolumic shock. So decision was taken for emergency laparotomy. After opening the abdomen rupture was found in the lower uterine segment extending upto upper part of cervix. So hysterectomy was performed and histopathology confirmed the diagnosis of ectopic pregnancy that developed in a Caesarean section scar Analysis of the womens obstetric history revealed that she had been previously operated because of breech presentation.Conclusion: Heightened awareness of the possibility of pregnancy in caesarean scar and early diagnosis by means of transvaginal sonography along with colour doppler can improve outcome and minimize the need for emergency extended surgeryBangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 83-86

Download Full-text

Chronic Tubal Ectopic Pregnancy with Diagnostic Conundrum: A Case Report

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20210435 ◽

2021 ◽

Vol 6 (2) ◽

pp. 192-194

Author(s):

Vishal Sharma ◽

Ravi Dutt Wadhwa

Keyword(s):

Case Report ◽

Ectopic Pregnancy ◽

Gestational Age ◽

First Trimester ◽

Present Case Report ◽

Tubal Ectopic Pregnancy ◽

Threatening Condition ◽

Life Threatening ◽

First Trimester Of Pregnancy ◽

Ectopic Pregnancies

Ectopic pregnancy is a life threatening condition and mostly ectopic pregnancies occurs in fallopian tube. The most common site of ectopic tubal pregnancy is ampulla. Ectopic pregnancy is a complication of pregnancy and usually easy to diagnose by ultrasonography during the first trimester of pregnancy. Due to limited healthcare resources in developing countries, women do not undergo for ultrasound examination during pregnancy which leads to late diagnosis. In most of cases women with ectopic pregnancy are asymptomatic, unless ruptured. The mean gestational age for clinical presentation of ectopic pregnancy is 7.2 weeks after the last normal menstrual period. In rural population, late presentations of ectopic pregnancies are more commonly seen because of lack of modern diagnostic ability. Present case report is a rare case of non-viable, unruptured, tubal ampullary chronic ectopic pregnancy of 12 weeks gestational age. Keywords: Ectopic pregnancy, Unruptured, gestational age, ultrasonography.

Download Full-text

A Case of Cervical Ectopic Pregnancy

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v27i1.29912 ◽

2016 ◽

Vol 27 (1) ◽

pp. 31-35

Author(s):

Jahanara Begum ◽

Shamsun Nahar Begum ◽

Rowshan Ara ◽

Shamim Fatema Nargis

Keyword(s):

Ectopic Pregnancy ◽

Uterine Cavity ◽

First Trimester ◽

Conservative Approach ◽

Artery Ligation ◽

Severe Hemorrhage ◽

Threatening Condition ◽

Life Threatening ◽

Ectopic Pregnancies ◽

Cervical Ectopic Pregnancy

Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervix1. Such pregnancy typically aborts within the first trimester, if it is implanted closer to the uterine cavity called cervico isthmic pregnancy it may continue longer2. Cervical pregnancy accounts for less than 1% of all ectopic pregnancies, with an estimated incidence of one in 2500 to one in 180003-5. Though the pregnancy in this area is uncommon but possibly life threatening condition due to risk of severe hemorrhage and may need hysterectomy. Early detection and conservative approach of treatment limit the morbidity and preserve fertility. A 26 years lady diagnosed as a case of cervical ectopic pregnancy and managed conservatively successfully with adjunctive techniques like cervical artery ligation and cervical temponade to control haemorrhage. The case is reported here for its relative rarity.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 31-35

Download Full-text

A RARE CASE OF CHRONIC ECTOPIC PREGNANCY

10.36106/ijsr/5629804 ◽

2021 ◽

pp. 1-2

Author(s):

Shridhar Dave ◽

Vishalkumar Bhardava ◽

Bhavya Shah

Keyword(s):

Ectopic Pregnancy ◽

Inflammatory Reaction ◽

Rare Case ◽

Minor Bleeding ◽

Threatening Condition ◽

Life Threatening ◽

Trophoblastic Tissue

Chronic ectopic pregnancy is a life threatening condition which is challenging to diagnose, occurs when trophoblastic tissue invades implanted structure causing a protracted destruction at site of attachment, leads to repeated minor bleeding. And with time a haematocele is formed, leading to inflammatory reaction and chronic pelvic adhesions which resemble complex pelvic mass1. Here 25 year old female presented with amenorrhea for 5 weeks with pain in abdomen and was diagnosed to have chronic ectopic pregnancy on MRI.

Download Full-text

A life-threatening condition – ruptured ectopic pregnancy with negative urine pregnancy test: A case report

Malaysian Family Physician ◽

10.51866/cr1117 ◽

2021 ◽

Vol 16 (1) ◽

pp. 121-123

Author(s):

Fadzilah Mohamad ◽

Ahmad Shuib Yahya ◽

Aneesa Abdul Rashid ◽

Navin Kumar Devaraj ◽

Abdul Hadi Abdul Manap

Keyword(s):

Abdominal Pain ◽

Emergency Management ◽

Ectopic Pregnancy ◽

Case Reports ◽

Rare Occurrence ◽

Pregnancy Test ◽

Threatening Condition ◽

Life Threatening ◽

Rule Out ◽

Urine Pregnancy Test

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

Download Full-text

A detailed study of methotrexate treatment in ectopic pregnancy

International Journal of Research in Hospital and Clinical Pharmacy ◽

10.33974/ijrhcp.v2i4.252 ◽

2020 ◽

Vol 2 (4) ◽

pp. 85-92

Author(s):

Alfiya R ◽

Sowparnika Treasa Sabu ◽

Shaiju S Dharan

Keyword(s):

Ectopic Pregnancy ◽

Selection Criteria ◽

Cardiac Activity ◽

First Trimester ◽

Relevant Article ◽

Activity Data ◽

Threatening Condition ◽

Life Threatening ◽

Methotrexate Treatment ◽

Data Collections

Methotrexate is a folic acid antagonist, it works by inhibiting the dihydrofolate by interfering with the DNA synthesis. Ectopic pregnancy is a life threatening condition that may cause maternal mortality. The main aim of this review to show the efficacy of systemic methotrexate and shows the importance of methotrexate treatment in management of ectopic pregnancy with surgical treatment and dosage regimen with protocol treatment. The selection criteria of candidates in this review is pregnant women with <5000miu/ml, adrenal mass <4cm, presence of peritoneum <100mland no sign of cardiac activity. Data collections are made from most relevant article between the periods of 1987-2020. Ectopic pregnancy is an emergency condition if not timely diagnosed and most of the cases where identified in first trimester.

Download Full-text